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Hysteroscopic removal of retained products of conception following first trimester medical abortion.
Gynecol Minim Invasive Ther. 2017 Oct-Dec; 6(4):183-185.GM

Abstract

Study Objective

To investigate the use of operative hysteroscopy instead of traditional curettage in women with retained products of conception (RPOC) following first trimester medical abortion, with the aim of reducing post-operative intrauterine adhesions.

Design

Retrospective study.

Setting

Gynecology department in a University affiliated hospital.

Patients

All women treated by hysteroscopy for RPOC following first trimester medical abortion using the mifepristone-misoprostol protocol for pregnancy termination or the misoprostol protocol for early missed abortion from January 2013 to August 2016.

Intervention

Operative hysteroscopy for removal of RPOC. Post-operative intrauterine adhesions were assessed by diagnostic office hysteroscopy after 6-8 weeks.

Measurements and Main Results

50 cases were identified. The mean time from medication administration to the operative hysteroscopy was 1.7 ± 0.7 months. Operative hysteroscopy with blunt use of the resectoscopic loop was used to remove all specimens, and all procedures were completed without intra-operative complications. Two patients (4.0%) were readmitted for fever. Pathology confirmed the presence of RPOC in 45 (90.0%) cases. On follow-up office hysteroscopy, a normal uterine cavity without evidence of intrauterine adhesions was seen in 29/29 (100%) women.

Conclusion

Hysteroscopy for removal of RPOC following medical abortion is associated with low rates of complications and post-operative intrauterine adhesions.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Affiliated with Tel-Aviv University, Sackler School of Medicine, Israel.Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Affiliated with Tel-Aviv University, Sackler School of Medicine, Israel.Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Affiliated with Tel-Aviv University, Sackler School of Medicine, Israel.Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Affiliated with Tel-Aviv University, Sackler School of Medicine, Israel.Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Affiliated with Tel-Aviv University, Sackler School of Medicine, Israel.Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Affiliated with Tel-Aviv University, Sackler School of Medicine, Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30254910

Citation

Smorgick, Noam, et al. "Hysteroscopic Removal of Retained Products of Conception Following First Trimester Medical Abortion." Gynecology and Minimally Invasive Therapy, vol. 6, no. 4, 2017, pp. 183-185.
Smorgick N, Levinsohn-Tavor O, Ben-Ami I, et al. Hysteroscopic removal of retained products of conception following first trimester medical abortion. Gynecology and minimally invasive therapy. 2017;6(4):183-185.
Smorgick, N., Levinsohn-Tavor, O., Ben-Ami, I., Maymon, R., Pansky, M., & Vaknin, Z. (2017). Hysteroscopic removal of retained products of conception following first trimester medical abortion. Gynecology and Minimally Invasive Therapy, 6(4), 183-185. https://doi.org/10.1016/j.gmit.2017.05.002
Smorgick N, et al. Hysteroscopic Removal of Retained Products of Conception Following First Trimester Medical Abortion. Gynecology and minimally invasive therapy. 2017 Oct-Dec;6(4):183-185. PubMed PMID: 30254910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hysteroscopic removal of retained products of conception following first trimester medical abortion. AU - Smorgick,Noam, AU - Levinsohn-Tavor,Orna, AU - Ben-Ami,Ido, AU - Maymon,Ron, AU - Pansky,Moty, AU - Vaknin,Zvi, Y1 - 2017/06/13/ PY - 2016/11/29/received PY - 2017/03/15/revised PY - 2017/05/23/accepted PY - 2018/9/27/entrez PY - 2018/9/27/pubmed PY - 2018/9/27/medline KW - abortion KW - hysteroscopy KW - intrauterine adhesions KW - retained products of conception SP - 183 EP - 185 JF - Gynecology and minimally invasive therapy VL - 6 IS - 4 N2 - Study Objective: To investigate the use of operative hysteroscopy instead of traditional curettage in women with retained products of conception (RPOC) following first trimester medical abortion, with the aim of reducing post-operative intrauterine adhesions. Design: Retrospective study. Setting: Gynecology department in a University affiliated hospital. Patients: All women treated by hysteroscopy for RPOC following first trimester medical abortion using the mifepristone-misoprostol protocol for pregnancy termination or the misoprostol protocol for early missed abortion from January 2013 to August 2016. Intervention: Operative hysteroscopy for removal of RPOC. Post-operative intrauterine adhesions were assessed by diagnostic office hysteroscopy after 6-8 weeks. Measurements and Main Results: 50 cases were identified. The mean time from medication administration to the operative hysteroscopy was 1.7 ± 0.7 months. Operative hysteroscopy with blunt use of the resectoscopic loop was used to remove all specimens, and all procedures were completed without intra-operative complications. Two patients (4.0%) were readmitted for fever. Pathology confirmed the presence of RPOC in 45 (90.0%) cases. On follow-up office hysteroscopy, a normal uterine cavity without evidence of intrauterine adhesions was seen in 29/29 (100%) women. Conclusion: Hysteroscopy for removal of RPOC following medical abortion is associated with low rates of complications and post-operative intrauterine adhesions. SN - 2213-3070 UR - https://www.unboundmedicine.com/medline/citation/30254910/Hysteroscopic_removal_of_retained_products_of_conception_following_first_trimester_medical_abortion_ L2 - https://linkinghub.elsevier.com/retrieve/pii/GMIT-6-183 DB - PRIME DP - Unbound Medicine ER -
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